How Is a Pessary Fitted?

A Guide from the PhysioFit of NC Women’s Health Physical Therapy Team

For many women experiencing pelvic organ prolapse (POP) or stress urinary incontinence (SUI), a pessary can be a game-changer. This small, removable medical device provides support for the pelvic organs and helps reduce symptoms like pressure, discomfort, and leakage.

But how exactly is a pessary fitted? What should you expect during the process? At PhysioFit of NC, we work closely with women to find the right solutions for their pelvic health. In this post, we’ll walk you through what to expect during a pessary fitting, from the initial consultation to finding the perfect fit.

---

Step 1: Initial Assessment

Before fitting a pessary, we conduct a comprehensive evaluation to determine whether a pessary is the right choice for you. This includes:

✔️ A pelvic floor assessment – We evaluate your pelvic muscle strength, vaginal tissue health, and the degree of prolapse or incontinence.
✔️ Symptom discussion – We talk about your specific concerns, daily activities, and goals to ensure the pessary meets your needs.
✔️ Medical history review – Certain factors, such as previous surgeries, vaginal dryness, or recurrent infections, may influence the type of pessary that works best.

💡 Who Can Benefit from a Pessary?
A pessary is often recommended for:

• Pelvic organ prolapse (bladder, uterus, or rectal prolapse)
• Stress urinary incontinence (SUI)
• Pregnancy-related pelvic support
• Postpartum recovery
• Women who want to avoid or delay surgery

---

Step 2: Choosing the Right Pessary Type

Pessaries come in different shapes and sizes depending on the condition being treated. The most commonly used types include:

🔵 Ring Pessary – Often used for mild to moderate prolapse and incontinence; some designs allow for sexual activity while in place.
🔵 Gellhorn Pessary – A firmer pessary with a disc and stem, ideal for more advanced prolapse.
🔵 Cube Pessary – Used when extra support is needed, but typically removed at night.
🔵 Continence Dish Pessary – Designed specifically for stress urinary incontinence.

Our goal is to find the most comfortable and effective option for your specific needs.

---

Step 3: The Fitting Process

Once we’ve chosen a pessary type, the fitting process begins:

✅ Trial Fitting – We insert a pessary of an estimated size and shape to assess comfort and effectiveness. You may be asked to stand, walk, cough, and bear down to check if it stays in place.
✅ Adjustments – If the pessary is too loose, too tight, or uncomfortable, we try a different size or design.
✅ Self-Management Training – If you choose a self-care pessary, we teach you how to insert, remove, and clean it properly. If you prefer a provider-managed pessary, we schedule regular check-ups for maintenance.

💡 How Should a Pessary Feel?
✔️ You should not feel pain or discomfort.
✔️ It should stay in place during movement.
✔️ You should be able to urinate and have bowel movements normally.

---

Step 4: Follow-Up & Ongoing Care

Once you have your pessary, regular check-ups are important to ensure:
✔️ It continues to fit well and relieve symptoms.
✔️ Your vaginal tissue remains healthy.
✔️ There are no signs of irritation or infection.

Most women come in for follow-up visits every 3-6 months, but schedules vary based on individual needs.

---

Why Work with a Women’s Health Physical Therapist for Pessary Fitting?

At PhysioFit of NC, we believe pessaries work best when combined with pelvic floor physical therapy. Strengthening and coordinating your pelvic floor muscles can improve pessary effectiveness and help manage prolapse and incontinence long-term.

If you’re curious about whether a pessary is right for you, we’d love to help! Contact our team today to schedule a consultation and take control of your pelvic health.